title: Osteochondral transplantation of the talus: long-term clinical and magnetic resonance imaging evaluation.
abstract: BACKGROUND
  Osteochondral lesions of the ankle are a common injury after ankle sprains, especially in young and active patients. The Osteochondral Autograft Transfer System (OATS) is the only 1-step surgical technique designed to replace the entire osteochondral unit.
  
  
  OBJECTIVE
  This study was conducted to evaluate the long-term clinical and radiographic outcomes of the OATS procedure for the talus and compare the results of patients who have had prior surgical interventions with patients for whom OATS represents the primary surgical treatment.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  The authors retrospectively analyzed 26 talus OATS procedures (25 patients) with an average follow-up of 84 months (range, 53-124 months); 9 patients had OATS as a second surgical intervention. The patients completed the American Orthopaedic Foot & Ankle Society (AOFAS) and Tegner scores plus the visual analog scale (VAS) preoperatively and at follow-up. Magnetic resonance imaging examinations were conducted on a 1.5-T whole-body magnet that assessed transplant congruency, adjacent surface of the talus, the corresponding distal tibia, and joint effusion.
  
  
  RESULTS
  The authors found significant increases for the AOFAS score (50 to 78 points, P < .01) and the Tegner score (3.1 to 3.7, P < .05) and a significant decrease for the VAS (7.8 to 1.5, P < .01) from preoperative to postoperative. Patients with normal integration or minor incongruity of the transplant on magnetic resonance imaging (81%) had significantly better AOFAS scores (P = .03). Other magnetic resonance imaging criteria did not predict clinical results. Patients for whom OATS represented a second procedure had significantly worse clinical AOFAS and Tegner scores plus a higher VAS.
  
  
  CONCLUSIONS
  Long-term clinical and magnetic resonance imaging results after osteochondral transplantation are good and patients significantly benefit from this surgery. Magnetic resonance imaging should not be a routine control but appears to be indicated when clinical symptoms persist after osteochondral transplantation.
authors.affiliation: Department of Orthopedic Sports Medicine, Technical University, Munich, Germany. a.imhoff@sportortho.de
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
authors.forename: Jochen
authors.initials: J
authors.lastname: Paul
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ottinger
authors.forename: Klaus
authors.initials: K
authors.lastname: Wörtler
authors.forename: Lena
authors.initials: L
authors.lastname: Lämmle
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Spang
authors.forename: Stefan
authors.initials: S
authors.lastname: Hinterwimmer
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016025:Bone Transplantation; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013628:Talus / Q000293:injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult